title: Treatment choices by seriously ill patients: the Health Stock Risk Adjustment model.
abstract: Anecdotal evidence suggests that patients who have life-threatening conditions often choose to undergo high-cost, high-risk treatments for them. This kind of risk-seeking behavior seems irrational because most patients are risk-averse. The Health Stock Risk Adjustment (HSRA) model seeks to explain this phenomenon. The model is based on the concept of relative health stock--the ratio of patients' expected quality-adjusted life years (QALYs) after a diagnosis to their expected QALYs before the diagnosis. The model predicts risk-averse patients will behave in a risk-seeking manner as their relative health stocks deteriorate. The HSRA model can help physicians better understand why some seriously ill patients seek high-risk treatments while others elect to forgo treatment. State legislatures and insurers are attempting to appropriately design insurance benefits for patients with life-threatening conditions. The HSRA model can help predict which patients will most likely take advantage of these benefits.
authors.affiliation: Institute for Health Care Research and Policy, Georgetown University Medical Center, Washington, DC 20007, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Gaskin
authors.forename: J
authors.initials: J
authors.lastname: Kong
authors.forename: N J
authors.initials: NJ
authors.lastname: Meropol
authors.forename: K R
authors.initials: KR
authors.lastname: Yabroff
authors.forename: C
authors.initials: C
authors.lastname: Weaver
authors.forename: K A
authors.initials: KA
authors.lastname: Schulman
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology; D003657:Decision Making; D003662:Decision Theory; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012309:Risk-Taking